Peripheral precocious puberty

Česká verzia

Authors: J. Zvonařová Skalická ¹; R. Pilka ²
Authors place of work: Středomoravská nemocniční a. s., nemocnice Šternberk, primář MUDr. M. Vaca ¹; Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. ²
Published in the journal: Ceska Gynekol 2016; 81(5): 377-383

Summary

Objective:
To summarize literature data on peripheral precocious puberty.

Design:
A literature review.

Setting:
Středomoravská nemocniční a.s., hospital Šternberk, Department of Obstetrics and Gynaecology, University Hospital, Medical Faculty, Palacky University, Olomouc.

Methods and results:
We searched in PubMed using the key words stated below according to date and published since 1980.

Peripheral precocious puberty occurs in girls with the frequency 1:
400–1000. It develops mainly because of peripheral estrogen secretion, the main cause of which are autonomous ovarian cysts. Other causes include McCune Albright syndrome, juvenile granulosa cell tumor and primary hypothyroidism. Typically, peripheral precocious puberty presents with early breast enlargement followed by development of other secondary sex characteristics. Initial treatment is usually conservative with the exception of juvenile granulosa cell tumor where surgery is warranted. Peripheral precocious puberty anti-estrogen therapy seems promising but neither data on its influence on fertility nor data comparing it to surgical treatment are available. Due to the risk of progression into central precocious puberty or McCune Albright syndrome, long-term follow-up is necessary.

Conclusion:
Peripheral precocious puberty should be managed in pediatric gynecology outpatient office and often subsides spontaneously. However, it can also be a sign of malignancy. In most cases, conservative therapy is preferred with medical treatment and surgery warranted in complicated cases. However, optimal treatment has not been established yet.

Keywords:
autonomous ovarian cyst, peripheral precocious puberty, McCune Albright syndrome, juvenile granulosa cell tumor, hypothyroidism

Zdroje

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